Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2021-07-06-20

Project Information

Project IdentifiersProject ID: 214579
DEA: 010B0904
EFIS: 0100020444
DIST-CO-RTE-PM01-DN-101-8.2/8.7
Award Date04/21/2020
Closeout DateNot set
Work DescriptionPanther Creek & Hunter Creek Bridges
Location DescriptionDEL NORTE COUNTY NEAR KLAMATH AT PANTHER CREEK BRIDGE AND AT HUNTER CREEK BRIDGE
QA Service Level1 (Verified on 03/02/2020)

Sample Information

Sample Taken Date07/06/2021 Sample Unique Key20
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testingNot set
Sample typeAcceptance A brief description of the sampleWashers
The quantity of what the sample constitutes716 From where was the sample collectedDistributor
First name of sampler or witnessed byChuck Last name of sampler or witnessed byFranco
Title of samplerQA Telephone number of sampler(858) 583-9270
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCascade Bolt Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormB75-015-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)
Heat Number(s)1234 Nut Mfg. Lot Number(s)
Washer Mfg. Lot Number(s)156889 Bolt SpecificationA325
Bolt Length(s) Nut SpecificationASTM A563
Washer SpecificationASTM F436 FinishPlain
Diameter/Size7/8" Bolt Mfg. Lot Number
Rocap Test Requirement(s) Lubricant Requirements(s)

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments